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The $100B per year back pain industry is mostly a hoax

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Re: The $100B per year back pain industry is mostly a hoax

#111

Earlier quoted context omitted.

I'm the GP. The reason why I'm replying is because I don't want people that can be helped by Acupuncture to reject it based on a misunderstanding of the claim. I think there are several specific reasons why both the article which you link to can be true and also that acpuncture worked in my specific case and can work in cases that are similar. First of all, as another reply alluded to, the article isn't testing for e…

Did you try a physical therapist? I had knee pain from rock climbing, and the usual "treatment" in this sport is just to rest and heal, but after 4 months I had no improvement. I had little faith in PT because I was convinced I had some kind of tear, or maybe a bone spur, etc. Anyway, the physical therapist put me through motions and he showed me on the skeleton how it was actually supporting muscles that were much w…

You found what causes a lot of chronic pain - muscle strength imbalances. Many times the pain and the imbalance are not intuitive, but a PT can give simple exercises to fix the imbalance and the pain goes away.

Posture can also be helped with muscle strengthening. Years ago a PT gave me a ton of exercises to combat sitting at a desk all day. I still do them at the end of my usual workouts.

Re: The $100B per year back pain industry is mostly a hoax

#112

I thought this community would be more scientific...instead of anecdotes I'd rather see links to rigorous studies e.g. showing acupuncture or chiropractors work especially since these two forms of intervention have been subjected to decades of research already, have no plausible scientific basis and claim to treat many more things besides back pain. They should be held to the same standards as other medicine.

The HN community is interesting in that respect and it's not only with some medical issues. As an example, any article on pesticides and modern food production will be full of comments decrying them and claiming health/taste benefits from alternatives. As you say, the community is surprisingly unscientific. Maybe that shouldn't be surprising because most people here probably have a technical and not scientific background and by virtue of having a reasonable disposable income are also the target demographic for products based on alternative science.

Re: The $100B per year back pain industry is mostly a hoax

#113

> Ramin reports that they are impossible to point at on an x-ray, because they don’t exist; a dislocated joint in your spine would be the result of a horrendous injury that sends you to the hospital, she explains, not to a massage table. The Chiropractor I visit utilizes x-rays & a thermographic scanner to identify the subluxations. From consistently seeing my x-rays, it's obvious where my subluxations lie. The therm…

> While it's healthy to be skeptical, it's also healthy to be skeptical of the skeptics.

Well said. Skepticism is important, but it's not an unerring guide to truth.

Re: The $100B per year back pain industry is mostly a hoax

#114

Earlier quoted context omitted.

I'm the GP. The reason why I'm replying is because I don't want people that can be helped by Acupuncture to reject it based on a misunderstanding of the claim. I think there are several specific reasons why both the article which you link to can be true and also that acpuncture worked in my specific case and can work in cases that are similar. First of all, as another reply alluded to, the article isn't testing for e…

Did you try a physical therapist? I had knee pain from rock climbing, and the usual "treatment" in this sport is just to rest and heal, but after 4 months I had no improvement. I had little faith in PT because I was convinced I had some kind of tear, or maybe a bone spur, etc. Anyway, the physical therapist put me through motions and he showed me on the skeleton how it was actually supporting muscles that were much w…

PT was really successful for me, too. No exercises per se, just a hip stretch and a recommendation to get orthotic shoe inserts and adopt a certain sleeping position.

Re: The $100B per year back pain industry is mostly a hoax

#115
post #51

Earlier quoted context omitted.

>>Acupuncture should, ideally, be tested separately for effectiveness for each individual condition for which it has been proposed (like so many other forms of alternative medicine, that is a very large number). Good quality trials have not been done for all of them, but results suggest strongly that it is unlikely that acupuncture works for rheumatoid arthritis, stopping smoking, irritable bowel syndrome, or for los…

First, you're taking a god-of-the-gaps approach to acupuncture. "It hasn't been proven to be ineffective for condition X, so keep your mind open!" Second, they have run good trials on many of the conditions acupuncture claims to cure. You picked the one paragraph that might be interpreted to support your claim: > It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, ra…

And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system.

I think western medicine is excellent when it comes to determining specific details about many individual bits are supposed to be working, and fixing those specific things when they're broken or malfunctioning. It's not as successful when it comes to understanding how all of those specific bits fit into place as part of a larger complex system. There are too many variables and interactions, and we've only very recently had the computational power to create models of these systems, let alone understand them.

Where western medicine takes a bottom-up approach, from details to system, non-western medicine usually takes a top-down approach, observing how the overall system behaves and reacts. With enough observations, it can become very good at predicting reactions, but still totally fail at being able to explain why the reactions happen.

Take acupuncture: in western medicine, we know that the body has pathways and circulatory systems for blood, lymph, and other fluids, and that our cells communicate using electrical, chemical, and hormonal signals that are passed through the pathways and circuits. We know a lot about small details, like how one nerve cell uses ions to pass an electrical charge across a fluid-filled gap to the next nerve cell, but we don't really know how it all works as a whole. But it stands to reason that poking conductive needles into these pathways and using them to cause stimulation could insert signals into the system or interrupt existing signals. Western medicine can't model that, and it can't predict for sure what possible effects it can have. Without a theory, all we can do is perform random experiments in the dark and hope something noticeable happens.

Chinese medicine, on the other hand, has done the random experiments over thousands of years, and has determined specific places to put the needles and how to manipulate them to get the desired effect. That's straight-up observational science. But to explain it the Chinese came up with the idea of qi as an energy that flows through the body, which is vaguely right as a very blurry view of western medicine's understanding of our nervous system and other systems, but mostly it's completely fictional.

The point I'm trying to make is that different approaches to understanding can both be right and both be wrong, except they tend to be right and wrong about different parts. The top-down, systemic, wholistic approach is good for understanding the big picture and the 'what', while the bottom-up, componentized, analytical approach is good for understanding 'how'.

Re: The $100B per year back pain industry is mostly a hoax

#116
i would like to share my experience. I have rheumatoid arthritis and have had it since age 13. I have been taking hydrocodone since i was 14, started taking oxycontin and hydrocodone for breakthrough 10 years ago at 25. I have been able to function as a normal person. I went through a few years of going off of them when i would gain mass amounts of weight and unable to do anything. I have only had my dosage adjusted twice, i am able to walk 6 miles a day plus go up and down 3 flights of stairs x16 times a day. Opiates have saved my life.

Re: The $100B per year back pain industry is mostly a hoax

#117
Back pain does attract a lot of quackery. It's hard to understand where people come from with back pain unless you experience it. It's debilitating and utterly dominates your life. But the article took many liberties to make it sound worse.

Spinal fusions in the lower spine are mostly done laproscopically these days, and usually don't involve abdominal surgery. That's a huge difference -- I had a 6 week recovery vs over 4 months for an abdominal procedure.

My L4-L5 was fused at age 25 due to a degenerated disc that failed completely. Fortunately it was very successful for me. Hopefully we make progress with artificial discs and vertebrae to improve outcomes for others.

Re: The $100B per year back pain industry is mostly a hoax

#118

At one time someone close to me was experiencing back pain, we both saw a lovely episode of the TV series 'Louie'. Here is a quote from that episode: Dr. Bigelow: What can I do for you? Louie: Uh, well, I hurt my back today really bad. Uh. Can you help me with my back? I mean... Dr. Bigelow: What's wrong with your back? Louie: It hurts. Dr. Bigelow: My professional diagnosis is your back hurts. Louie: Well, what can…

Digging the joke, but is there any scientific truth to this statement?

> It was designed to be horizontal. Then people came along and used it vertical. Wasn't meant for that.

Re: The $100B per year back pain industry is mostly a hoax

#119

At one time someone close to me was experiencing back pain, we both saw a lovely episode of the TV series 'Louie'. Here is a quote from that episode: Dr. Bigelow: What can I do for you? Louie: Uh, well, I hurt my back today really bad. Uh. Can you help me with my back? I mean... Dr. Bigelow: What's wrong with your back? Louie: It hurts. Dr. Bigelow: My professional diagnosis is your back hurts. Louie: Well, what can…

Sure it's an engineering problem but why not dive into imagining a solution now, no reason to wait 'till your ancestors evolve wheels (or whatever).

The spine is similar to a set of disks stacked on top of each other. There's no reason that sort of structure can't be fairly stable when held upright. A wide variety of movement arts, martial arts and healing arts mention the damage involved in letting one's spine sag forward (or backward).

Of course getting the spine, neck and head to work together harmoniously is more complex than just "holding yourself upright". Just willing one's body to hold particular relaxed, upright stance can often result in the opposite.

That's why a lot of body work, body awareness, martial arts and etc work on an indirect principle. Meditate so your conscious mind stops screwing up your body and mind. Allow another person to show you the right stance and accept it without judgment.

Which is to say the process of trying to practically engineer the body to work effectively has been going on for a long time. Unlike a cure or prescription, this kind of engineering pretty has to be specific to the person, requires the person's active participation. And so-forth.

See, Tai Chi, qigong, the Alexander Technique, the FeldenKrais method, etc, etc, etc, etc...

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